While genetic predisposition certainly contributes to obesity, the existing racial/ethnic disparities in obesity remain largely unexplained. Women are at special risk for developing obesity during childbearing;however, the relationship between weight gain before, during and after pregnancy may differ between black, Hispanic, and non-Hispanic white women. Maternal obesity at conception and/or excessive weight gain during pregnancy may also significantly influence the development and programming of metabolic processes in offspring - impacts which may also vary by race/ethnicity. Therefore childbearing represents an important developmental window within which to explore the origins of racial/ethnic disparities in obesity - for both mothers and their children. The purpose of this project is to investigate racial/ethnic differences in the impact and interactions between several factors that may increase maternal BMI at mid-life as well as obesity in offspring: early maternal social environment (e.g., socioeconomic status and family structure), pregnancy- related weight (e.g., excessive gestational weight gain and postpartum weight retention), and adverse maternal childhood experiences (e.g., physical abuse, substance abuse or mental illness in the home). The U.S. 1979 National Longitudinal Survey of Youth (NLSY) and its companion study of children born to NLSY females provide a valuable data set to conduct a cohort study. These highly respected, nationally representative studies of approximately 4000 U.S. women and their children provide a unique opportunity to assess parity- related weight, socioeconomic and psychological factors, and BMI across one generation of mothers and their children. An innovative feature of this proposal is the collection of new data on history of maternal adverse childhood experiences in the 2012 wave of the NLSY. We will capitalize on expertise of collaborators from institutions that have worked together previously on other research projects and whose expertise spans the fields of perinatal epidemiology, nutrition and obesity, neurobiology, health disparities, psychology, social epidemiology and biostatistics. We hypothesize that: 1) after adjusting for pre-pregnancy BMI and current social environment, excessive gestational weight gain and postpartum weight retention will mediate the association between early social disadvantage and mid-life BMI and that this mediation will be larger for black women;2) after adjusting for current social environment, a mother's early social environment and high weight before, during and after pregnancy represent pathways through which racial disparities in offspring obesity are increased;and 3) maternal history of childhood adverse experiences will explain a substantial portion of the association between early social environment and pregnancy weight gain with maternal and child BMI, adjusting for current social environment.
The combination of early childhood adversity and excessive gestational weight gain during pregnancy together suggest a potential unexplored pathway which may contribute to racial/ethnic disparities in obesity in women and their children. Understanding how maternal early life experiences and maternal weight before, during and after pregnancy, contribute, individually and jointly, to the development of maternal and child obesity by race/ethnicity stands to open the door for the development of novel approaches to obesity prevention.
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